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What are the Appropriate wounds for Maggot Therapy?
Feb 22, 2018 by Bethanie,
2 replies
Elaine Horibe Song
MD, PhD, MBA
Hi Bethanie, thank you so much for your question and welcome to WoundReference!
Maggot therapy can be used for most types of wounds that contain adherent slough or soft necrotic tissue, or wounds that are clinically infected not responding to antibiotic therapy (e.g. pressure injuries, diabetic foot ulcers, chronic leg ulcers, or non-healing traumatic or post-operative wounds). It works particularly well for diabetic foot ulcers because maggots selectively debride necrotic dead tissue. It may be a valid alternative to surgical/sharp debridement.
Among ulcers/patients that typically are not great candidates for larval therapy we can cite: wounds that do not have enough blood supply for healing to take place, dry wounds, fistulae, wounds that have exposed vessels/ nerves or are close to vessels or nerves, granulating wounds, highly exudative wounds (maggots may drown) or that bleed easily. Caution should be exercised in wounds located in weight bearing areas, wounds treated with hydrogels (kills maggots), patients using anticoagulants. Patients may also not feel comfortable knowing that these are real live larvae and may prefer some other alternative :)
Here you can find suppliers/products related to larval therapy
Debridement: Larval Therapy
Please let me know if I have answered your question or if more information is needed.
Feb 22, 2018
Excellent response. maggot therapy is not for everyone. Its a burdensome process for clinics not using them on a regular basis and they have to be changed out every few days because the maggots get "full". In terms of patients, many are squeamish about having maggots on their bodies and some can feel them moving around and it gives them the creeps.

They do do a great job of debridement for those that can pull off their utilization.
Feb 22, 2018
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